Provider Demographics
NPI:1508962499
Name:TRI-VALLEY SCHOOL DISTRICT
Entity Type:Organization
Organization Name:TRI-VALLEY SCHOOL DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERINTENDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:L
Authorized Official - Last Name:HERB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-682-9013
Mailing Address - Street 1:110 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY VIEW
Mailing Address - State:PA
Mailing Address - Zip Code:17983-9423
Mailing Address - Country:US
Mailing Address - Phone:570-682-9013
Mailing Address - Fax:
Practice Address - Street 1:110 W MAIN ST
Practice Address - Street 2:
Practice Address - City:VALLEY VIEW
Practice Address - State:PA
Practice Address - Zip Code:17983-9423
Practice Address - Country:US
Practice Address - Phone:570-682-9013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1013145650001Medicaid